What’s in a number: Falling on the sword of cut-off points and reference limits?

Journal of the Colleges of Medicine of South Africa

 
 
Field Value
 
Title What’s in a number: Falling on the sword of cut-off points and reference limits?
 
Creator Gounden, Verena Moodley, Nareshni
 
Subject — reference intervals; clinical decision limits; interpretation; laboratory; biological variation
Description The marked increase in laboratory test volumes and costs internationally emphasises the need for demand management. One way that this can be implemented is by reducing unnecessary repeat testing with the provision of appropriate decision cut-off points (clinical decision limits [CDLs]) or reference intervals (RIs) with subsequent correct interpretation of laboratory results. The derivation of RIs and CDLs are fraught with technical and biological challenges. There is difficulty in conducting labour-intensive, costly, long, and complex studies, which require healthy volunteers that represent things such as different age groups, genders, races, and alternate states of health (e.g. pregnancy) within the population. It is also inappropriate to apply RIs or cut-off points from other populations, which is often what occurs when manufacturer-expected values are used. Lack of standardisation of international guidelines for CDLs and analytical methods poses a further problem. The effect of analytical and biological variation on results is also essential to consider when interpreting results. These make ideal RIs and CDLs difficult to attain and implement despite their critical need.
 
Publisher AOSIS
 
Contributor
Date 2025-06-30
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/jcmsa.v3i1.148
 
Source Journal of the Colleges of Medicine of South Africa; Vol 3, No 1 (2025); 4 pages 2960-110X 3105-4331
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://jcmsa.org.za/index.php/jcmsa/article/view/148/609 https://jcmsa.org.za/index.php/jcmsa/article/view/148/610 https://jcmsa.org.za/index.php/jcmsa/article/view/148/611 https://jcmsa.org.za/index.php/jcmsa/article/view/148/612
 
Coverage — — —
Rights Copyright (c) 2025 Verena Gounden, Nareshni Moodley https://creativecommons.org/licenses/by/4.0
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